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<TITLE>Consent Form for Contributors of Personal Histories to the History of Adoption in Australia project</TITLE>
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<DIV id="header">
  <H1>History of Adoption in Australia</H1>
  <DIV id="logos"><IMG src="static/logo-monash.jpg" alt="Monash University logo" name="logo_monash" width="208" height="34" id="logo_monash"><BR>
    <IMG src="static/acu-logo.jpg" width="248" height="35" alt="Australian Catholic University logo" id="logo_acu"></DIV>
  <DIV class="clear_both"></DIV>
</DIV>
<DIV id="content">
  <H2>Consent Form for Contributors of Personal Histories</H2>
  <P class="note"><STRONG>Note:</STRONG> This consent form is to be completed online. A copy will remain with the Monash and Australian Catholic University researchers for their records. <BR>
    <BR>
    <p>If you require any help with creating the audio version of your story, please view the <A href="help.html" target="_blank">Help page</A>.</p>
  <P class="required">* denotes required fields</P>
  <FORM id="hoa_consent" name="hoa_consent" method="post" action="uploadfile.jsp" enctype="multipart/form-data">
    <FIELDSET class="" id="part_2">
      <LEGEND><A href="#" id="part_2_legend">Agreement</A></LEGEND>
      <DIV id="fieldbody_part_2">

       
<p>I agree to take part in the Monash–ACU University research project
 specified above. I am over the age of eighteen years old. I have read the 
 <a href="explanatory-statement.html">explanatory statement</a>, which I keep 
 for my records. I have also accessed the Monash University 
 <a href="http://www.privacy.monash.edu.au/procedure/index.html">Privacy 
 Statement</a>.
</p>
<p>I understand that my participation in the project is voluntary. I understand too that
 remembering and retelling my experience of adoption may be painful and stressful, and that
 assistance can be obtained from a number of agencies offering post-adoption support, whose
 telephone contact details are available through the <a 
 href="https://confluence-vre.its.monash.edu.au/display/hoa/Adoption+support+resources">History
  of Adoption website</a>.
</p>
<p>I understand that my story will be posted on the History of Adoption Project website, and that
 it will be publicly available to everyone with internet access. I understand that my story will
 also be placed in a permanent archive so that it will continue to be publicly accessible after
 the History of Adoption Project ends. Despite the Project's terms and conditions, my material 
 may be reproduced, downloaded or uploaded to other websites by third parties, including for
 commercial purposes. I note that the Project has a statement on its website to help prevent 
 this, but these actions by third parties may be beyond the Project’s control.
</p>
<p>I understand that there are privacy regulations that prevent the History of Adoption Project 
 from identifying other people in my story. This includes members of my immediate family.
 In telling my story I will not intentionally use the names of other individuals, and any
 information that could lead to the identification of any individual will be removed from the
 published stories and not disclosed in any reports on the project, or to any other party, except
 that my own name can be used when I specifically give permission for this.
</p>
<p>I understand that the researchers may change particular details in my story before it is 
 released to the website, in order to satisfy privacy regulations. I understand that I will be 
 given access to the edited version of my story for my approval before it is made available on 
 the project website and/or included in the write up of the research. I understand that I will be 
 informed via the website of any publications arising from the research.
</p>
<p>I agree to treat all knowledge and all knowledge makers involved in the project with respect,
 including knowledge which does not accord with my own understandings.
</p>
<p>I understand that I own the copyright of the story I contribute to this website, but that the 
 researchers associated with the project will have the right to reproduce that material, subject
 to the conditions set out above. This means that I retain ownership of my story and I can 
 grant permission to others to reproduce it.</p>
<p></p>

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            <LABEL>
              <INPUT type="radio" name="age" value="yes" id="age_0" onclick="MM_changeProp('too_young','','display','none','DIV');document.getElementById('details').className = '';document.getElementById('details').style.display = 'block';document.getElementById('Submit').style.display = 'block';MM_changeProp('warning2','','display','none','P')">
              I understand and agree to the above information. I have also read the <a href="explanatory-statement.html">Explanatory Statement</a> and the <a href="http://www.privacy.monash.edu.au/procedure/index.html">Privacy Statement</a>.<SPAN class="required">*</SPAN></LABEL>
            <BR>
            <LABEL>
              <INPUT type="radio" name="age" value="no" id="age_1" onclick="MM_changeProp('too_young','','display','block','DIV');document.getElementById('details').style.display = 'none';document.getElementById('Submit').style.display = 'none';MM_changeProp('warning2','','display','none','P')">
              I do not agree</LABEL>
          </P>
        </DIV>
        <DIV id="too_young" class="error">
          <P>Thank you for your desire to participate but unfortunately you must agree to the above information before proceeding.</P>
        </DIV>
      </DIV>
    </FIELDSET>
    <FIELDSET class="" id="part_1">
      <LEGEND></LEGEND>
      <DIV id="fieldbody_part_1">
        <P>I would like to:<SPAN class="required">*</SPAN> </P>
        <DIV id="spryradio1">
          <P class="radioRequiredMsg" id="warning1">Please make a selection.</P>
          <P>
            <LABEL>
              <INPUT name="story" type="radio" value="yes-researcher" id="story_0" onclick="document.getElementById('part_2').className = '';MM_changeProp('warning1','','display','none','P');MM_changeProp('instruct_upload','','display','none','DIV')">
              Have my story <b>recorded by a researcher</b> from the project and posted to the website.</LABEL>
          </P>
          <P>OR</P>
          <P>
            <LABEL>
              <INPUT name="story" type="radio" value="yes-own" id="story_1" onclick="MM_changeProp('part_2','','display','block','FIELDSET');document.getElementById('part_2').className = '';MM_changeProp('warning1','','display','none','P');MM_changeProp('instruct_upload','','display','block','DIV')">
              <b>Post my own story</b> on the project website, as an audio or text file.</LABEL>
          </P>
        </DIV>
        <DIV id="instruct_upload" class="note">
          <P>You will be able to upload the audio or text file of your story after submitting this form.</P>
        </DIV>
      </DIV>
    </FIELDSET>    
    <FIELDSET class="" id="details">
      <LEGEND><A href="#" id="details_legend">Participant details</A></LEGEND>
      <DIV id="fieldbody_details">
        <P id="sprytextfield1">
          <LABEL><SPAN class="question">Given Name(s):</SPAN><SPAN class="required">*</SPAN><BR>
            <INPUT name="participant_name" type="text" id="participant_name" size="60" onchange="MM_changeProp('warning3','','display','none','SPAN');document.getElementById('participant_name').style.backgroundColor = '#FFF'" autocomplete="off">
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          <br/>
          <LABEL><SPAN class="question">Surname:</SPAN><SPAN class="required">*</SPAN><BR>
            <INPUT name="participant_surname" type="text" id="participant_surname" size="60" onchange="MM_changeProp('warning3','','display','none','SPAN');document.getElementById('participant_name').style.backgroundColor = '#FFF'" autocomplete="off">
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          <LABEL><SPAN class="question">Address line 1:</SPAN><SPAN class="required">*</SPAN><BR>
            <INPUT name="address_line_1" type="text" id="address_line_1" size="60" onchange="MM_changeProp('warning4','','display','none','SPAN');document.getElementById('address_line_1').style.backgroundColor = '#FFF'" autocomplete="off">
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        <P>
          <LABEL><SPAN class="question">Address line 2:</SPAN><BR>
            <INPUT name="address_line_2" type="text" id="address_line_2" size="60">
          </LABEL>
        </P>
        <P id="sprytextfield3">
          <LABEL><SPAN class="question">City/Town:</SPAN><SPAN class="required">*</SPAN><BR>
            <INPUT name="city" type="text" id="city" size="60" onchange="MM_changeProp('warning5','','display','none','SPAN');document.getElementById('city').style.backgroundColor = '#FFF'" autocomplete="off">
          </LABEL>
          <SPAN class="textfieldRequiredMsg" id="warning5">Please enter your city/town.</SPAN> </P>
        <P id="spryselect1">
          <LABEL><SPAN class="question">State:</SPAN><SPAN class="required">*</SPAN><BR>
            <SELECT name="state" id="state" onchange="MM_changeProp('warning6','','display','none','SPAN');document.getElementById('state').style.backgroundColor = '#FFF'">
              <OPTION>--select--</OPTION>
              <OPTION value="ACT">ACT</OPTION>
              <OPTION value="NT">NT</OPTION>
              <OPTION value="NSW">NSW</OPTION>
              <OPTION value="QLD">QLD</OPTION>
              <OPTION value="SA">SA</OPTION>
              <OPTION value="TAS">TAS</OPTION>
              <OPTION value="VIC">VIC</OPTION>
              <OPTION value="WA">WA</OPTION>
            </SELECT>
          </LABEL>
          <SPAN class="selectRequiredMsg" id="warning6">Please select your state.</SPAN></P>
        <P id="sprytextfield4">
          <LABEL><SPAN class="question">Email:</SPAN><SPAN class="required">*</SPAN><BR>
            <INPUT name="email" type="text" id="email" size="60" onblur="checkEmailConfirm(this); return checkEmail(this);" onchange="MM_changeProp('warning10','','display','none','SPAN');document.getElementById('email').style.backgroundColor = '#FFF'" autocomplete="off">
          </LABEL>
          <SPAN class="textfieldRequiredMsg" id="warning10">Please enter your email address.</SPAN> <SPAN class="error" id="warning9">Not a valid email address.</SPAN> </P>
         <P id="sprytextfield4"> 
          <LABEL><SPAN class="question">Confirm Email:</SPAN><SPAN class="required">*</SPAN><BR>
            <INPUT name="confirm_email" type="text" id="confirm_email" size="60" onblur="return checkEmailConfirm(this)" onchange="MM_changeProp('warning111','','display','none','SPAN');document.getElementById('confirm_email').style.backgroundColor = '#FFF'" autocomplete="off">
          </LABEL>          
          <SPAN class="textfieldRequiredMsg" id="warning111">Please enter your email address.</SPAN> <SPAN style="display: none" class="error" id="warningMatch">Email addresses don't match</SPAN> </P>
        </P>
        <P class="question">My name can be publicly linked to my story:<SPAN class="required">*</SPAN></P>
        <DIV id="spryradio3">
          <P class="radioRequiredMsg" id="warning7">Please make a selection.</P>
          <P>
            <LABEL>
              <INPUT type="radio" name="publicly_linked" value="yes" id="publicly_linked_0" onclick="MM_changeProp('warning7','','display','none','P')">
              Yes</LABEL>
            <BR>
            <LABEL>
              <INPUT type="radio" name="publicly_linked" value="no" id="publicly_linked_1" onclick="MM_changeProp('warning7','','display','none','P')">
              No</LABEL>
          </P>
        </DIV>
        <P class="question">My experience of adoption is as:<SPAN class="required">*</SPAN></P>
        <DIV id="spryradio4">
          <P class="radioRequiredMsg" id="warning8">Please make a selection.</P>
          <P>
            <LABEL>
              <INPUT type="radio" name="experience" value="Adopted" id="experience_0" onclick="MM_changeProp('warning8','','display','none','P')">
              An adopted person</LABEL>
            <BR>
            <LABEL>
              <INPUT type="radio" name="experience" value="Separated Parent" id="experience_1" onclick="MM_changeProp('warning8','','display','none','P')">
              A separated parent, or some other relative</LABEL>
            <BR>
            <LABEL>
              <INPUT type="radio" name="experience" value="Adopting" id="experience_2" onclick="MM_changeProp('warning8','','display','none','P')">
              An adopting parent, or some other relative</LABEL>
            <BR>
            <LABEL>
              <INPUT type="radio" name="experience" value="Professional" id="experience_3" onclick="MM_changeProp('warning8','','display','none','P')">
              A professional advising/assisting with adoption</LABEL>
            <BR>
            <LABEL>
              <INPUT type="radio" name="experience" value="Other" id="experience_4" onclick="MM_changeProp('warning8','','display','none','P')">
              Some other relationship with adoption</LABEL>
          </P>
        </DIV>
        <P class="question">Date of the adoption (if applicable): </P>
        <P>
          <LABEL>
            <INPUT type="radio" name="date_adoption" value="Pre-1940" id="date_adoption_0">
            Pre-1940</LABEL>
          <BR>
          <LABEL>
            <INPUT type="radio" name="date_adoption" value="1940s" id="date_adoption_1">
            1940s</LABEL>
          <BR>
          <LABEL>
            <INPUT type="radio" name="date_adoption" value="1950s" id="date_adoption_2">
            1950s</LABEL>
          <BR>
          <LABEL>
            <INPUT type="radio" name="date_adoption" value="1960s" id="date_adoption_3">
            1960s</LABEL>
          <BR>
          <LABEL>
            <INPUT type="radio" name="date_adoption" value="1970s" id="date_adoption_4">
            1970s</LABEL>
          <BR>
          <LABEL>
            <INPUT type="radio" name="date_adoption" value="1980s" id="date_adoption_5">
            1980s</LABEL>
          <BR>
          <LABEL>
            <INPUT type="radio" name="date_adoption" value="1990s" id="date_adoption_6">
            1990s</LABEL>
          <BR>
          <LABEL>
            <INPUT type="radio" name="date_adoption" value="2000s" id="date_adoption_7">
            2000s</LABEL>
        </P>
        <P class="question">Place of the adoption (if applicable): </P>
        <P class="required">(Please choose an option from each of the lists below)</P>
        <P style="float:left; margin-right: 20px">
          <LABEL>
            <INPUT type="radio" name="adoption_region" value="Regional" id="adoption_region_0">
            Regional</LABEL>
          <BR>
          <LABEL>
            <INPUT type="radio" name="adoption_region" value="Metropolitan" id="adoption_region_1">
            Metropolitan</LABEL>
        </P>
        <P style="float:left; margin-left: 20px">
          <LABEL>
            <INPUT type="radio" name="adoption_state" value="ACT" id="adoption_state_0">
            Australian Capital Territory</LABEL>
          <BR>
          <LABEL>
            <INPUT type="radio" name="adoption_state" value="NSW" id="adoption_state_1">
            New South Wales</LABEL>
          <BR>
          <LABEL>
            <INPUT type="radio" name="adoption_state" value="NT" id="adoption_state_2">
            Northern Territory</LABEL>
          <BR>
          <LABEL>
            <INPUT type="radio" name="adoption_state" value="QLD" id="adoption_state_3">
            Queensland</LABEL>
          <BR>
          <LABEL>
            <INPUT type="radio" name="adoption_state" value="SA" id="adoption_state_4">
            South Australia</LABEL>
          <BR>
          <LABEL>
            <INPUT type="radio" name="adoption_state" value="TAS" id="adoption_state_5">
            Tasmania</LABEL>
          <BR>
          <LABEL>
            <INPUT type="radio" name="adoption_state" value="VIC" id="adoption_state_6">
            Victoria</LABEL>
          <BR>
          <LABEL>
            <INPUT type="radio" name="adoption_state" value="WA" id="adoption_state_7">
            Western Australia</LABEL>
          <BR>
          <LABEL>
            <INPUT type="radio" name="adoption_state" value="other" id="adoption_state_8">
            other: </LABEL>
          <INPUT type="text" name="adoption_place" id="adoption_place">
        </P>
      </DIV>
    </FIELDSET>
    <P>
      <INPUT type="submit" name="Submit" id="Submit" value="Submit">
    </P>
  </FORM>
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